Secondary Service Connection: How Conditions Caused or Worsened by Another Qualify

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The rule — 38 CFR § 3.310

• § 3.310(a) – proximately due to / result of: a disability caused by a service-connected condition is itself service connected.
• § 3.310(b) – aggravation: a non-service-connected condition that gets worse beyond its natural progress because of a service-connected condition is compensable for the degree of aggravation. VA needs a medical baseline of the condition's severity before aggravation.

The three elements

1. A current diagnosed disability (the secondary condition).
2. A service-connected primary disability.
3. Medical nexus evidence that the primary caused or aggravated the secondary — when the evidence is in approximate balance, the reasonable doubt is resolved in the veteran's favor (38 CFR § 3.102).

Common pairings (each still needs medical evidence)

| Primary | Frequently claimed secondary | |---|---| | PTSD / depression | sleep apnea (via weight gain or meds — evidence varies), GERD from medication, erectile dysfunction from SSRIs, hypertension | | Knee condition | opposite knee, hip, or low back from altered gait | | Lumbar spine | radiculopathy (rated separately, e.g., DC 8520), ED, depression | | Diabetes mellitus II | peripheral neuropathy, ED, kidney disease, retinopathy | | Tinnitus | anxiety/depression (sleep disruption) |

How to file

Claim on VA Form 21-526EZ, naming the condition "secondary to [primary]". Attach a nexus opinion and treatment records. See C&P exam & nexus letter guide.

Related existing articles: secondary-conditions-increase-va-rating, secondary-conditions-to-back-injury, secondary-mental-health-conditions-to-ptsd, nexus-letter-secondary-conditions.